Safety and efficacy of nitric oxide in chronic lung disease
Safety and efficacy of nitric oxide in chronic lung disease
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DOI：
10.1136/fn.86.1.f41
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发表时间：
2002-01-01
影响因子：
4.4
通讯作者：
Truog, WE
中科院分区：
文献类型：
--
作者：
Clark, PL;Ekekezie, II;Truog, WE
背景资料：早产儿慢性肺疾病（CLD）的治疗成功率有限。目的：确定吸入一氧化氮（INO）是否可改善极低出生体重儿CLD的氧合而无不良反应。方法：受试者年龄为10-30天，出生体重< 1250 9，患有发展中或确诊的CLD，平均气道压≥ 7 cm H2O，Flo（2）≥ 0.40，需机械通气。我们监测了INO（初始剂量20 ppm）治疗期间氧合和Flo（2）需求的变化。在治疗前、期间和之后获得的气管吸出物样本分析白细胞介素1 β（IL-1 β）、IL-8、8-表-前列腺素F-2 α（8-epi-PGF（2 α））、层粘连蛋白和内皮素1（ET-1），以评估作者对INO对炎症过氧化、基底膜损伤或血管活性标记物的任何潜在影响的关联。平均胎龄为25（SD 2）周;出生体重为736（190 9）;研究婴儿的年龄为19（6）天（范围9-29）。平均Flo（2）从基线（0.75）降至72小时时的0.58。治疗持续时间为7天，气管抽吸物浓度、IL-1 β、IL-8、8-epi-PGF（2 α）、ET-1和层粘连蛋白浓度在基线和INO治疗48小时以及INO停药后48小时之间无变化。未发生脑室内出血的新病例或扩大。四名婴儿死亡。INO（小于或等于20 ppm）改善了大多数早期CLD婴儿的氧合，而不诱导炎症或氧化损伤标志物的变化。
Background: Therapies for neonatal chronic lung disease (CLD) of prematurity have had limited success Aims: To determine whether inhaled nitric oxide (INO) administered to very low birthweight infants with developing CLD might improve oxygenation without adverse effects.Methods: Subjects were 10-30 days of age, birth weight < 1250 9, with developing or established CLD, and requiring mechanical ventilation with mean airway pressure greater than or equal to7 cm H2O and Flo(2) greater than or equal to0.40. We monitored changes in oxygenation and Flo(2) requirement during treatment with INO (initial dose 20 ppm). Tracheal aspirate samples obtained before, during, and after treatment were analysed for inter leukin 1beta (IL-1beta), IL-8, 8-epi-prostagiandin F-2alpha (8-epi-PGF(2alpha)), laminin, and endothelin 1 (ET-1) to assess authors' affiliations any potential effects of INO on markers of inflammation peroxidation, basement membrane injury, or vasoactivity.Results: Thirty three patients met entry criteria. Mean gestational age was 25 (SD 2) weeks; birth weight was 736 (190 9); age of study infants was 19 (6) days (range 9-29). Mean Flo(2) decreased from baseline (0.75) to 0.58 at 72 hours. Duration of therapy was seven days, Tracheal aspirate con, centrations of IL-1beta, IL-8, 8-epi-PGF(2alpha), ET-1, and laminin were unchanged between baseline and 48 USA; hours of INO, and 48 hours after discontinuation of INO. No new cases of, nor extension of, intraventricular haemorrhage occurred. Four infants died.Conclusion: INO (less than or equal to20 ppm) improved oxygenation in most infants with early CLD, without inducing changes in markers of inflammatory or oxidative injury.